Liquid Biopsy in Hepatocellular Carcinoma

NCT ID: NCT04111029

Last Updated: 2023-05-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-01-16

Study Completion Date

2024-03-31

Brief Summary

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Circulating tumor DNA (ctDNA) carrying tumor-specific sequence alterations has been found in the cell-free fraction of blood. Hepatocellular carcinoma (HCC) specimens are difficult to obtain, and noninvasive methods are required to assess cancer progression and characterize underlying genomic features. Use of 'liquid biopsy' by assessing circulating cell free DNA enables the clinician to offer targeted immunotherapy or signaling pathway inhibitors. It also offers a model to prove response to locoregional or immunotherapy therapy and predict tumor recurrence non-invasively.

Detailed Description

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Novelty:

Mutation analysis may not only help identify cancer drivers, but they can also provide useful data to predict response to other treatment modalities such as immunotherapies, particularly immune checkpoint blockade. There is published data on liquid biopsy in India from oncology in the field of pulmonary and renal cancers, but these studies have not been done in cirrhosis or in HCC patients.

Objectives In this project we hope to develop a biomarker panel which helps us prognosticate patients and tailor targeted therapy as per their genetic mutation landscape. The treatment options for advanced HCC are limited, and tissue biopsy is not routinely performed.

Methods In this pilot project, we will analyze 30 patients with unresectable hepatocellular carcinoma, ineligible for liver transplantation, who will undergo locoregional therapy in the form of transarterial chemoembolization (TACE) or radioembolization (TARE) for tissue diagnosis of tumor tissue DNA and circulating tumor DNA. We will design personalized assays targeting somatic rearrangements of each tumor to quantify serum ctDNA. Exome sequencing will be performed using cell-free DNA and paired primary tumor tissue DNA in order to create a non-invasive liquid biopsy for diagnosis and prognostication of HCC.

Conditions

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Hepatic Carcinoma Malignant Primary Non-Resectable

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Unresectable HCC undergoing locoregional therapy

Patients with unresectable HCC who have no curative option like tumour ablation, resection or transplantation and are being taken for locoregional therapy will be recruited

Cell Free DNA

Intervention Type DIAGNOSTIC_TEST

Pre and post procedure plasma cell free DNA will be assessed for response to locoregional therapy

Interventions

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Cell Free DNA

Pre and post procedure plasma cell free DNA will be assessed for response to locoregional therapy

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Liquid biopsy

Eligibility Criteria

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Inclusion Criteria

* Hepatocellular carcinoma BCLC stages B and C of all aetiology, unresectable
* Age 18-70 years of either sex

Exclusion Criteria

* Contemplating Hepatic resection or OLT
* Refractory ascites
* Severe Coagulation disorders prior to the procedure (PTI \<70% and Platelet count \< 80,000/mm3)
* Hepato-Renal syndrome
* Chronic Kidney Disease
* Acute decompensation like Hepatic encephalopathy and variceal bleeding
* Any known malignancy other than HCC
* Life expectancy \< 6 months
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Post Graduate Institute of Medical Education and Research, Chandigarh

OTHER

Sponsor Role lead

Responsible Party

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Madhumita Premkumar

Assistant Professor, Department of Hepatology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Radhika Srinivasan, MD PhD

Role: STUDY_CHAIR

Post Graduate Institute of Medical Education and Research, Chandigarh

Locations

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Postgraduate Institute of Medical Education and Research

Chandigarh, Choose Any State/Province, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Madhumita Premkumar, MD DM

Role: CONTACT

01722754777

Harman Dhaliwal, MSc

Role: CONTACT

0117087003409

Facility Contacts

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Madhumita Premkumar

Role: primary

Other Identifiers

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INT/HEP/1078

Identifier Type: -

Identifier Source: org_study_id

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